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10 doctor focus cannabis patient care | vol. 2 no. 3 cannapatientcare.com Women are looking for solutions, not looking to get high. They're looking for ways to live their life the way they want to. With symptoms like pain, anxiety, and nausea or vomiting, they aren't going to be able to function in these crazy busy lives that they have where they're not just taking care of themselves but also their families, they're working, they're involved in the community. When I hear about a problem that stands as a barrier to liv- ing their best quality of life then I'll say: 'Well what have you been doing to improve that?' Many patients will say they're afraid of pharmaceuticals, and afraid of dependence. They want natural remedies, not drugs that can make them feel intoxicat- ed. So that's a natural way to ask if they've considered medical cannabis. It's part of the holistic way we help people recover. Q: Why are so many healthcare providers apprehensive about talking with their patients about cannabis? A: Dr. Weiss: Most doctors in the breast cancer communi- ty are apprehensive for a variety of reasons. First, cannabis is not part of most medical schools' curriculum, so most doctors are without any formal training. In the absence of insurance, you would need a second track in your practice just to handle it. Another important component is that none of it is integrated into the electronic medical record for patients, so it's not integrated within a patient's holistic care within the traditional medical system like pharmaceuticals are. If I were to see somebody and they were to go to a dispensary to get products, the list of products they get from a dispensary are not entered into the database, so you have no idea what types of products your patients are using. That's an uncomfort- able place for a doctor to be in; you qualify someone for a medicine but you don't know what they're taking, in many cases they don't know what they're taking. They're not allowed to bring the product on campus to show you what they're taking because it's illegal. So there's a lot of logistical requirements that are deterrents. Most importantly, even though we have about 34+ states that have legal programs, cannabis is still illegal at the federal level, and many doctors do not feel comfortable talking about prod- ucts that are illegal. Even when it is legal at the federal lev- el doctors may not be comfortable until there is a scientific re- search foundation on which to base recommendations. So that is why I'm committed clinically to perform vital foundation- al research to determine what our needs are, patterns of use, knowledge, attitudes, behaviors, and beliefs to determine the role of cannabis, and to have it based on something scientific. Q: What would help encourage more health- care providers to recommend cannabis? A: Dr. Weiss: Well the main thing that has to occur is cannabis medicine education in medical schools and the commitment to research. Because we have many individual anecdotes, for centuries, of the individually reported value of products but it has not been collected in a scientific format. So we need better clinical trials to collect data on the effectiveness and the role it plays in the treatment of cancer. Q: Can you tell us about your chemothera- py-induced peripheral neuropathy (CIPN) study? A: Dr. Weiss: I decided to identify a clinical problem that was really awful and common for which medical cannabis seemed to have a unique role. That is in the treatment of patients with chemotherapy-induced peripheral neuropathy (CIPN); symptoms include pain, numbness, as well as pins and needles in the hand from some of the most commonly used chemotherapy. Medications that are commonly used in most cancers but especially breast, colon, colorectal, ovarian, and uterine cancer. The data we had showed that cannabis could play a role in preventing that problem as well as treating that problem. This came from a study on mice that a woman named About the Interviewee DR. MARISSA WEISS is the author of four critically ac- claimed books on breast cancer and breast health: Living Beyond Breast Cancer and Living Well Beyond Breast Cancer, coauthored with her mother, Ellen Weiss (1998, 2010); Taking Care of Your "Girls:" A Breast Health Guide for Girls, Teens, and In-Betweens, coauthored with her daughter, Isabel Friedman (2008); and 7 Minutes!: How to Get the Most from Your Doctor Visit (2007). A renowned leader in the field of breast cancer, Dr. Weiss is frequent- ly called on by the media as a subject matter expert and respected voice of breast cancer patients.